Vitrectomy
What is Vitrectomy ?
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Why do you need Vitrectomy ?
Vitrectomy is indicated for:
- Vitreous hemorrhage:
- Bleeding into the vitreous (e.g., diabetic retinopathy, retinal vein occlusion); obscures vision.
- Retinal detachment:
- Rhegmatogenous: Vitrectomy removes traction and allows retinal reattachment.
- Tractional: Scar tissue (e.g., diabetic retinopathy) pulls retina; vitrectomy relieves traction.
- Macular conditions:
- Epiretinal membrane (macular pucker): Scar tissue on macula; causes distorted vision.
- Macular hole: Hole in the macula; causes central vision loss.
- Vitreomacular traction:
- Vitreous pulls on the macula, causing distortion or edema.
- Other conditions:
- Endophthalmitis: Severe infection; vitrectomy removes infected vitreous.
- Retained lens fragments: After cataract surgery complications.
- Floaters: Severe, vision-impairing floaters (less common).
The procedure aims to clear the vitreous, repair retinal issues, and restore or preserve vision by replacing the vitreous with saline, a gas bubble, or silicone oil.
Why Do Vitrectomy Costs Vary in Philippines?
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Vitrectomy procedure
- Before Surgery Evaluation:
- Diagnosis:
- Dilated fundus exam: Assesses retina, macula, and vitreous.
- Optical coherence tomography (OCT): Evaluates macula (e.g., for macular hole, epiretinal membrane).
- Ultrasound (B-scan): Visualizes retina if vitreous hemorrhage obscures view.
- Visual acuity test: Measures vision loss.
- Blood tests: Blood sugar (for diabetics), clotting profile.
- Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; antibiotic eye drops (e.g., moxifloxacin) 1 day pre-surgery.
- Consent: Risks, including infection, are explained.
- Diagnosis:
- Surgical Techniques:
- Vitrectomy:
- Performed under local anesthesia (peribulbar block) or general anesthesia, lasting 1–3 hours.
- Three small incisions (23–27 gauge) are made in the sclera: one for infusion (saline to maintain eye pressure), one for a light source, and one for the vitrector.
- The vitreous gel is removed using a vitrector (cutting and suction device).
- Additional steps depend on the condition:
- Retinal detachment: Peel scar tissue, laser/cryotherapy to seal tears.
- Macular hole/pucker: Peel membrane, may use gas for closure.
- Vitreous hemorrhage: Clear blood, treat underlying cause (e.g., laser for diabetic retinopathy).
- The vitreous cavity is filled with:
- Gas bubble (e.g., SF6, C3F8): Absorbs in 2–8 weeks; requires head positioning.
- Silicone oil: Used in complex cases; removed later (3–6 months).
- Saline: Temporary replacement (less common).
- Incisions are self-sealing or sutured (if needed).
- Intraoperative Tools:
- Vitrector: Removes vitreous gel.
- Endolaser: Seals retinal tears.
- Gas/silicone oil: Tamponade agents to support retina.
- Vitrectomy:
- After Surgery:
- Hospital stay: 1–2 days.
- Eye care: Antibiotic/steroid drops (e.g., prednisolone, moxifloxacin) for 4–6 weeks; artificial tears for dryness.
- Pain management: Mild to moderate pain for 2–5 days; managed with acetaminophen.
- Positioning: Face-down or specific head position for 1–2 weeks if gas used; critical for macular hole closure or retinal reattachment.
- Instructions: Avoid air travel or high altitudes (with gas bubble), heavy lifting, or strenuous activity for 4–6 weeks.
Recovery After Vitrectomy
- Hospital Stay: 1–2 days.
- Post-Surgery Care:
- Vision: Blurry for weeks due to gas bubble or oil; improves in 1–3 months; varies by condition (e.g., macular hole: 50–70% regain useful vision).
- Pain: Mild to moderate for 2–5 days; managed with analgesics.
- Eye care: Antibiotic/steroid drops for 4–6 weeks; artificial tears for 1–2 months.
- Activity: Avoid heavy lifting or strenuous activity for 4–6 weeks; normal activities (e.g., reading) in 1–2 weeks.
- Positioning: Face-down or specific head position for 1–2 weeks (gas bubble); critical for success.
- Gas bubble: Absorbs in 2–8 weeks; silicone oil removed after 3–6 months (additional surgery).
- Follow-Up:
- Visits at 1 day, 1 week, 1 month, then every 3 months for 1 year to monitor retina and vision.
- OCT: Assesses macula at 1–3 months (e.g., for macular hole closure).
Most resume normal activities in 4–6 weeks; full recovery takes 3–6 months. Success rate: 85–90% achieve anatomical success (e.g., retinal reattachment, hole closure); vision improvement varies (vitreous hemorrhage: 70–90% regain good vision; macular hole: 50–70%).
Risks and Complications
- Surgical Risks:
- Infection (endophthalmitis, <0.1%): Rare; causes pain, vision loss; needs urgent treatment.
- Bleeding (1–3%): Vitreous hemorrhage; may resolve or need repeat surgery.
- Raised intraocular pressure (5–10%): Temporary; managed with drops; glaucoma risk with silicone oil.
- Post-Surgery:
- Cataract (30–50% within 1–2 years): Accelerated by vitrectomy/gas; may need cataract surgery.
- Retinal detachment (5–10%): New tears or failure to reattach; may need additional surgery.
- Macular edema (5–10%): Swelling in macula; may need injections (e.g., anti-VEGF).
- Macular hole failure (10–20%): Hole doesn’t close; may need repeat surgery.
- Long-Term:
- Silicone oil complications (5–10%): Emulsification, glaucoma, or corneal damage; requires removal.
- Vision distortion (5–10%): If macula damaged; may not fully recover.
Report sudden vision loss, severe pain, or increased redness promptly.
Frequently Asked Questions (FAQs)
What conditions require vitrectomy?
Vitreous hemorrhage, retinal detachment, macular hole, epiretinal membrane, vitreomacular traction, endophthalmitis, or retained lens fragments.
Can I avoid vitrectomy?
Sometimes; vitreous hemorrhage may resolve spontaneously (e.g., 3–6 months); retinal detachment or macular hole often requires surgery to prevent permanent vision loss.
Is vitrectomy painful?
No, performed under anesthesia; mild to moderate pain for 2–5 days, managed with medication.
How soon can I resume activities?
Light activities in 1–2 weeks; normal routines in 4–6 weeks; full recovery in 3–6 months.
Is vitrectomy covered by insurance in India?
Yes, for medical necessity; confirm with your provider.
Signs of complications?
Sudden vision loss, severe pain, or increased redness.
Will my vision return to normal?
Depends on condition; vitreous hemorrhage: 70–90% regain good vision; macular hole: 50–70% improve; retinal detachment varies (macula-on better prognosis).
Lifestyle changes post-surgery?
Follow positioning instructions, avoid air travel (with gas bubble), use prescribed drops, avoid strenuous activity for 4–6 weeks, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Vitrectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.